S단백 결핍에 동반된 양측성 급성 신경색

• Published in: Kidney research and clinical practice Vol. 29; no. 5; pp. 616 - 621
• Main Authors: 김태원, Tae Won Kim, 강건우, Gun Woo Kang, 홍효림, Hyo Lim Hong, 문성희, Sung Hee Mun, 이인희, In Hee Lee, 안기성, Ki Sung Ahn
• Format: Journal Article
• Language: Korean
• Published: 대한신장학회 30.09.2010
• Subjects: Infarction; Protein S deficiency
• ISSN: 2211-9132

Acute renal infarction usually occurs in patients with trauma, atrial fibrillation, atherosclerosis, vasculitis, and valvular heart disease. However, it may occur, though rarely, in patients with hypercoagulable states such as protein C and protein S deficiency. We report here a case of acute bilateral renal infarction associated with type II protein S deficiency without a demonstrable underlying cause. A 48- year-old male was presented to the emergency room with an abrupt, persistent pain at the left flank area. Three-dimensional abdominal computed tomography revealed wedge-shaped, well demarcated, low density lesions in both the kidneys, which were consistent with occlusions of segmental branches of both the renal arteries. Protein S activity by clot-based assay was 43% (73.7-146.3%). The patient was treated with intravenous heparin and later warfarin. He has remained symptom-free on warfarin therapy with preserved renal function during the follow-up of 5 weeks.